Hepatocellular Carcinoma Arising in an HNF-1α-Mutated Adenoma in a 23-Year-Old Woman with Maturity-Onset Diabetes of the Young: A Case Report.

Abstract

Hepatocyte nuclear factor-1α mutated hepatocellular adenomas (H-HCA) are thought to have no to minimal malignant potential. This report describes a 23-year-old woman with maturity-onset diabetes of the young who developed a 12.5-cm hepatic mass with a radiographically and pathologically distinct 3.0-cm region. Histologically and immunohistochemically, the bulk of the mass was an H-HCA with extensive pseudoglandular formation and only focal steatosis. The 3.0-cm nodule showed small cell change, thickened hepatocyte plates, pleomorphic and hyperchromatic nuclei, reticulin loss, and stromal and vascular invasion, diagnostic of hepatocellular carcinoma (HCC). Immunohistochemically, increased expression of glutamine synthetase in tumor cells and CD34 expression in sinusoidal endothelial cells were seen in the HCC component. Nuclear expression of β-catenin, and exon 3 of CTNNB1 and TERT promoter mutations were absent in this case. Thus, we report a HCC arising in an H-HCA; although cases appear exceedingly rare, they reinforce the potential of H-HCA for malignant transformation.

• Authors: Ashley E Stueck, Zhenhong Qu, Mary Ann Y Huang, Genís Campreciós, Linda D Ferrell, Swan N Thung
• Journal: Seminars in liver disease (Semin Liver Dis) Vol. 35 Issue 4 Pg. 444-9 (Nov 2015) ISSN: 1098-8971 [Electronic] United States
• PMID: 26676820 (Publication Type: Case Reports, Journal Article)
• Copyright: Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Chemical References

• Hepatocyte Nuclear Factor 1-alpha

Topics

• Adenoma, Liver Cell (complications, diagnosis, genetics)
• Carcinoma, Hepatocellular (complications, diagnosis, genetics)
• Cell Transformation, Neoplastic
• Diabetes Mellitus, Type 2 (complications)
• Female
• Hepatocyte Nuclear Factor 1-alpha (genetics)
• Humans
• Liver (diagnostic imaging, pathology)
• Liver Neoplasms (complications, diagnosis, genetics)
• Neoplasms, Multiple Primary (diagnosis, genetics)
• Tomography, X-Ray Computed
• Young Adult